[Critical analysis on risk factors of postoperative in-hospital complications in radical cystectomy of bladder cancer].

OBJECTIVE

To evaluate the risk factors associated with the in-hospital complications of radical cystectomy.

METHODS

The records of 128 consecutive patients who underwent radical cystectomy from November 2006 to October 2009 were reviewed. Preoperative, intraoperative risk variables were defined based on POSSUM score and APACHE II score. ASA score and m-ACCI score were used to evaluate the co-mobidities. All variables were analyzed to evaluate the risk factors associated with in-hospital complications of radical cystectomy.

RESULTS

In the 128 patients undergoing radical cystectomy, 58 patients (45.31%) had complications, with 51 (39.84%) minor complicatons and 7 (5.47%) major complications. Wound dehiscence or unhealing (22.66%), infection (20.31%) and ileus (17.19%) were the most common complications. The risk factors related to the in-hospital complications of radical cystectomy are age > or = 65 yr. (P < 0.001,OR = 1.067), volume of intraoperative blood transfusion > or = 600 mL (P = 0.023, OR = 1.001), m-ACCI score (P < 0.001, OR = 1.583), ASA score > or = III (P = 0.003, OR = 2.411), partial cystectomy history (P = 0.025 OR = 2.444), intraoperative heart rate > 120 beats/min (P < 0.001, OR = 11.861).

CONCLUSIONS

Wound complication, postoperative infection and ileus are the most common complications of radical cystectomy. Age, volume of intraoperative blood transfusion, m-ACCI score, ASA score, partial cystectomy history and intraoperative heart rate are significant risk factors.